Correlation between left atrial size, prothrombotic state and markers of endothelial dysfunction in patients with lone chronic nonrheumatic atrial fibrillation

Atrial fibrillation is associated with a prothrombotic state and endothelia l dysfunction. To understand whether the prothrombotic state was correlated with endothelial dysfunction and whether the latter was related to atrial dimension (endocardial damage), we studied systemic hemocoagulative activit y and markers of endothelial dysfunction in 45 patients with chronic nonrhe umatic atrial fibrillation and in 35 controls. We assessed fibrinogen, anti thrombin III, protein C, markers of platelet activation (platelet factor 4 and beta -thromboglobulin) as markers of fibrinolysis, and D-dimer, tissue plasminogen activator, plasminogen activator inhibitor, von Willebrand's fa ctor and soluble thrombomodulin as endothelial dysfunction. Plasma fibrinog en (P < 0.005), platelet factor 4 (P < 0.001), thromboglobulin (P < 0.001), D-dimer (P < 0.03), tissue plasminogen activator (P < 0.006), plasminogen activator inhibitor (P < 0.04) and both von Willebrand's factor (P < 0.0001 ) and soluble thrombomodulin (P < 0.03) were significantly higher in the pa tients than in the controls. Positive significant linear correlations were found between fibrinogen and markers of endothelial dysfunction and left at rial volume and fibrinogen or markers of endothelial dysfunction. These fin dings confirm that chronic nonrheumatic atrial fibrillation is associated w ith a prothrombotic state but also suggest that there is a correlation betw een endothelial dysfunction, coagulation factors and left atrial dimension. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.